Alzheimer’s / Self Help

Complementary Therapies / Alternative Medicine

Both patients and carers can benefit from alternative approaches to life and complimentary therapies from the moment of diagnosis onward. This is one of the conditions where complementary therapies have shown very worthwhile results.

In terms of how we see and make sense of life, the challenge of Alzheimer’s couldn’t be more profound. How do you deal with the prospect of losing past memories and facing a distressing future? As a carer, how do you deal with the thought of all the challenges and loss to come?

Having done a great deal of research on this, and been told what’s essential by carers who’ve now become authorities on the subject, the most profound advice we’ve heard is: be here now. The past is gone. The future doesn’t exist. An asteroid could blow us all up tomorrow. Now is all there really is. The person with Alzheimer’s is on a road of having no choice but to live in the moment. Past and future are gone. Do likewise to connect most profoundly with him or her. It will help you to connect on the deepest and always available level. This is easier to say than to do, but the Shollond Trust’s simple techniques – under meditation in our Complementary Techniques and Therapies Guide – are among those which actually do make it possible.

Quite a few complimentary and alternative therapies and techniques can give you practical ways to let go of the imaginary future, be calmed and connected to the present, and improve your condition in a number of ways. The following may also help:

Aromatherapy

Aromatherapy is the therapeutic use of essential oils derived from plants. The oils can usually be:

Applied directly to the skin, often accompanied by massage

Heated in an oil burner to produce a pleasant odour

Placed in a bath.

The oils are concentrated and should be used according to instructions – they must be diluted, for example, before being applied to the skin. An aromatherapist can work with the patient and help carers to use this technique.

Research funded by the Mental Health Foundation in 2000 highlighted the potential benefits of aromatherapy, specifically the use of melissa officinalis, or lemon balm, in the treatment of Alzheimer’s disease. Researchers at Newcastle University’s Medicinal Plant Research Centre believe that lemon balm may help prevent the loss of the key brain chemical acetylcholine. Lemon balm may then work in the same way as the first generation of drugs for Alzheimer’s disease, Aricept and Exelon. This research suggests that aromatherapy may have a more specific role in the treatment of Alzheimer’s than aiding relaxation.

In 2002, a paper by Alistair Burns in the British Medical Journal added weight to the potential benefits of aromatherapy for people with dementia, used as an alternative to neuroleptic drugs.

Massage

There is some evidence that massage – either alone or in combination with aromatherapy – is effective in helping people with dementia to relax. A number of studies have shown such benefits from massage and touch therapies. Massage with lavender oil has shown a reduction in agitated behaviour.

Music Therapy

Music therapy is the creative use of musical improvisation by both client and practitioner to create a relationship in which healing can take place. A review of music therapy for dementia concluded that, based on the available evidence, it can be beneficial in treating symptoms and improving the quality of life of people with dementia and their carers. The Guideposts Trust says that “Even when brain function is affected by illness, music continues to ‘make sense’ for nearly everyone”. They highly recommend music therapy, See our HIT list for contacts.

Meditation

Recommended for most conditions, for life in general, and very much for Alzheimer’s. Some meditation techniques can be learned in a few moments and be effective for both early-stage patients and for carers. As we’ve said, see the website of the Shollond Trust in our Complementary Techniques and Therapies Guide. Also see BBC Health in Look Here First.

Melatonin and Bright Light Therapy

The hormone melatonin, released by the pineal gland and considered important in regulating sleeping behaviour, has been cited as a beneficial supplement for patients with sleep disturbances. Sleep disorders and disruptive nocturnal behaviour associated with dementia present a significant clinical problem. A characteristic pattern of sleep disturbance referred to as ‘sundowning’ has been described. This shows itself in increased arousal and activity, usually in the late afternoon, evening or night and is a cause of increased stress for carers.

There is considerable theoretical evidence to support the use of melatonin as a treatment for sleep disturbance associated with dementia. Melatonin is a hormone implicated in the control of the sleep-wake cycle. It is stimulated during darkness and suppressed by light. While the effects of melatonin have been extensively studied in animals, there is growing evidence that melatonin is also involved in the regulation and control of sleep and waking patterns in humans. Dementia appears to disturb these patterns.

Bright light therapy may also be useful, but possibly not in combination with melatonin. Consult the Alzheimer’s Society and talk to your doctor about the availability, appropriateness and use of these therapies.

Be sure to see ourcomplementary techniques and therapies guideto get a feel for the better known Self-Help options. They can be very useful at earlier stages, some can help as the disease progresses, and many can have value for carers throughout:

Supplements, Snake-oils and Diets

Vitamin D: Mounting evidence suggests that vitamin D protects the brain by breaking down and clearing Alzheimer’s disease related proteins, protecting the blood supply to the brain and preventing the death of brain cells themselves. Dietary supplements are already widely used to safely increase vitamin D levels and improve bone health at minimal cost, and may therefore have enormous therapeutic potential for the prevention and treatment of Alzheimer’s and dementia. The Peninsula School of Medicine is making some leading progress on this. We can’t yet say what an effective dose might be, but over the counter vitamin D3 up to 4,000 IU is considered safe for ordinary daily use. As always, check Medline Plus to learn more about dosage and safety.

Vitamin E supplements have been proposed as potentially benefiting people with Alzheimer’s. No clear value demonstrated so far, and the jury is out. See Medline Plus for up to date information. Most people can take a standard daily dose of vitamin E without side effects – However, any change in medications should first be discussed with a primary care physician because all medication can cause side effects or interactions with other medications. A person taking “blood-thinners,” for example, may not be able to take Vitamin E or will need to be monitored closely by a physician. Dosage must be controlled. Vitamin E is harmful in excessive doses.

Ginkgo Biloba

Ginkgo biloba is a plant extract containing several compounds that may have positive effects on cells within the brain and the body. Ginkgo biloba is thought to have both antioxidant and anti-inflammatory properties, to protect cell membranes, and to regulate neurotransmitter function. Ginkgo has been used for centuries in traditional Chinese medicine and currently is being used in Europe to alleviate cognitive symptoms associated with a number of neurological conditions.

In a study of Alzheimer’s patients published in the Journal of the American Medical Association (October 22/29, 1997), Pierre L. Le Bars, MD, PhD, of the New York Institute for Medical Research, and his colleagues observed in some participants a modest improvement in cognition, activities of daily living (such as eating and dressing), and social behaviour. Results from this study show that ginkgo may help some individuals with Alzheimer’s disease, but further research is needed to determine the exact mechanisms by which Ginkgo works in the body. Also, results from this study are considered preliminary because of the low number of participants, about 200 people.

Few side effects are associated with the use of Ginkgo, but it is known to reduce the ability of blood to clot, potentially leading to more serious conditions, such as internal bleeding. This risk may increase if Ginkgo biloba is taken in combination with other blood-thinning drugs, such as aspirin and warfarin. Currently, multicenter trial with about 3,000 participants is investigating whether Ginkgo may help prevent or delay the onset of Alzheimer’s disease or vascular dementia.

Huperzine A

Huperzine A (pronounced HOOP-ur-zeen) is a moss extract that has been used in traditional Chinese medicine for centuries. Because it has properties similar to those of U.S. Food and Drug Administration approved Alzheimer medications, it has been promoted as a treatment for Alzheimer’s disease.

Evidence from small studies shows that huperzine A may be effective to some degree. Large-scale trials are needed to better understand the effectiveness of this supplement.

In Spring 2004, the National Institute on Aging (NIA) launched the first U.S. clinical trial of huperzine A as a treatment for mild to moderate Alzheimer’s disease. Because huperzine A is a dietary supplement, it is unregulated and manufactured with no uniform standards. If used in combination with approved Alzheimer drugs, an individual could increase the risks of serious side effects. Check with your doctor.

Omega-3 Fatty Acids

Omega-3s are a type of polyunsaturated fatty acid (PUFA). Research has linked certain types of omega-3s to a reduced risk of heart disease and stroke.

Research has also linked high intake of omega-3s to a possible reduction in risk of dementia or cognitive decline. The chief omega-3 in the brain is DHA, which is found in the fatty membranes that surround nerve cells, especially at the microscopic junctions where cells connect to one another.

A Jan. 25, 2006, literature review by the Cochrane Collaboration found that published research does not currently include any clinical trials large enough to recommend omega-3 supplements to prevent cognitive decline or dementia. But the reviewers found enough laboratory and epidemiological studies to conclude this should be a priority area for further research. According to the review, results of at least two larger clinical trials were expected.

Theories about why omega-3s might influence dementia risk include their benefit for the heart and blood vessels; anti-inflammatory effects; and support and protection of nerve cell membranes.

A report in the April 2006 Nature described the first direct evidence for how omega-3s might have a helpful effect on nerve cells (neurons). Working with laboratory cell cultures, the researchers found that omega-3s stimulate growth of the branches that connect one cell to another. Rich branching creates a dense “neuron forest,” which provides the basis of the brain’s capacity to process, store and retrieve information.

Kanpo Preparations

‘Kanpo’ is a Japanese variant of Chinese traditional medicine. Kanpo preparations using medicinal herbs have shown some possible benefits for patients with dementia. To be approached with care, and check our sources in Look Here First regarding this and any traditional or herbal treatments. As always it’s important to tell your doctor if you’re trying any of these – if only to prevent bad interactions with other medications.

Coral Calcium

This would appear to qualify as a “snake oil”, or product we would warn against. Coral calcium supplements have been heavily marketed as a cure for Alzheimer’s disease, cancer, and other serious illnesses. Coral calcium is a form of calcium carbonate claimed to be derived from the shells of formerly living organisms that once made up coral reefs.

In June 2003, the United States Federal Trade Commission (FTC) and the Food and Drug Administration (FDA) filed a formal complaint against the promoters and distributors of coral calcium. The agencies state that they are aware of no competent and reliable scientific evidence supporting the exaggerated health claims and that such unsupported claims are unlawful.

Coenzyme Q10

Possibly another “snake oil”. Coenzyme Q10, or ubiquinone, is an antioxidant that occurs naturally in the body and is needed for normal cell reactions to occur. This compound has not been studied for its effectiveness in treating Alzheimer’s. A synthetic version of this compound, called idebenone, was tested for Alzheimer’s disease but did not show favourable results. Little is known about what dosage of coenzyme Q10 is considered safe, and there could be harmful effects if too much is taken.